<div class="inn-tip">您需填写真实信息，否则将影响申请分期。</div>

<!-- 姓名 -->
<div class="weui-cell">
    <div class="weui-cell__hd">
        <label class="weui-label">姓名</label>
    </div>
    <div class="weui-cell__bd">
        <input class="weui-input" id="name" type="text" placeholder="请输入您的姓名">
    </div>
</div>

<!-- 联系电话 -->
<div class="weui-cell">
    <div class="weui-cell__hd">
        <label class="weui-label">联系电话</label>
    </div>
    <div class="weui-cell__bd">
        <input class="weui-input" id="phone" type="tel" placeholder="请输入11位手机号码">
    </div>
</div>

<!-- 身份证照片（正反面） -->
<!-- <div class="weui-cell">
  <div class="weui-cell__bd">
    <div class="weui-uploader">
      <div class="weui-uploader__hd">
        <p class="weui-uploader__title">身份证照片（正反面）</p>
        <div class="weui-uploader__info">查看示例</div>
      </div>
      <div class="weui-uploader__bd">
        <div class="weui-uploader__input-box">
          <input id="uploaderInput" class="weui-uploader__input" type="file" accept="image/*" multiple="">
        </div>
      </div>
      <div class="weui-uploader__ft">最多可上传2张</div>
    </div>
  </div>
</div> -->

<!-- 每月房租 -->
<div class="weui-cell">
    <div class="weui-cell__hd">
        <label class="weui-label">每月房租</label>
    </div>
    <div class="weui-cell__bd">
        <input class="weui-input" id="rental" type="number" placeholder="请输入">
    </div>
</div>

<!-- 是否合租 -->
<div class="weui-cell weui-cell_select weui-cell_select-after">
    <div class="weui-cell__hd">
        <label for="" class="weui-label">是否合租</label>
    </div>
    <div class="weui-cell__bd">
        <select class="weui-select" id="rentalType" name="rentalType" required>
            <option value="" selected disabled hidden>请选择</option>
            <option value="整租">整租</option>
            <option value="合租">合租</option>
        </select>
    </div>
</div>

<!-- 所在城市 -->
<div class="weui-cell weui-cell_select weui-cell_select-after">
    <div class="weui-cell__hd">
        <label for="" class="weui-label">所在城市</label>
    </div>
    <div class="weui-cell__bd">
        <select class="weui-select" name="select2" required>
            <option value="" selected disabled hidden>请选择</option>
            <option value="2">美国</option>
            <option value="3">英国</option>
        </select>
    </div>
</div>

<!-- 详细地址 -->
<div class="weui-cell">
    <div class="weui-cell__bd">
        <textarea class="weui-textarea" id="address" placeholder="详细地址（示例：上海市南京东路980弄4号502室）" rows="2"></textarea>
    </div>
</div>

<!-- 房东称呼 -->
<div class="weui-cell">
    <div class="weui-cell__hd">
        <label class="weui-label">房东称呼</label>
    </div>
    <div class="weui-cell__bd">
        <input class="weui-input" id="landlordName" type="text" placeholder="请输入">
    </div>
</div>

<!-- 房东电话 -->
<div class="weui-cell">
    <div class="weui-cell__hd">
        <label class="weui-label">房东电话</label>
    </div>
    <div class="weui-cell__bd">
        <input class="weui-input" id="landlordPhone" type="tel" placeholder="请输入">
    </div>
</div>
<div class="inn-tip inn-tip-inner">未征求您的同意，我们不会擅自联系房东</div>

<!-- 申请按钮 -->
<div class="weui-btn-area">
    <a class="weui-btn" href="javascript:;" id="js-submit">申请房租月付</a>
</div>
